简介:随着器官保留理念被外科医师广泛接受,保留十二指肠的胰头切除术(DPPHR)逐渐被用于治疗胰头部肿块型慢性胰腺炎及良性或低度恶性肿瘤。DPPHR手术区域解剖及血供复杂,术后易发生并发症。笔者在经典DPPHR术式上进行改良,提出保留十二指肠胰头全切除术(DPtPHR)。本文就上述要难点对DPtPHR手术方式的演变、手术操作的要点及手术适应证的选择进行简介。DPtPHR的操作要点在于完整切除胰头及病变组织、保障十二肠血供与防止胆道损伤与缺血,其适应证主要包括胰头肿块型慢性胰腺炎、浆液/黏液囊腺瘤、G1/G2级神经内分泌肿瘤、实性假乳头状瘤与分支型导管内乳头状瘤。值得注意的是,需要结合术前影像检查、术中探查与冰冻快速切片明确诊断并排除癌变。
简介:Foralargefloatingvesselinwaves,radiationdampingisnotanaccuratepredictionofthedegreeofrollunlikeotherdegreesoffreedommotion.Therefore,togettheknowledgeofrollmotionperformanceofdeepwaterpipelaycranevesselsandtokeepthevesselworkingsafety,thepaperpresentstherelationshipbetweenaseriesofdimensionlessrolldampingcoefficientsandtherollresponseamplitudeoperator(RAO).Byusingtwokindsofempiricaldata,therolldampingisestimatedinthecalculationflow.Aftergettingtherolldampingcoefficientfromthemodeltest,apredictionofrollmotioninregularwavesisevaluated.Accordingtothewaveconditionintheworkingregion,shorttermstatisticsofrollmotionarepresentedunderdifferentwaveparameters.Moreover,therelationshipbetweenthemaximalrollresponseleveltopeakspectralwaveperiodandtherolldampingcoefficientisinvestigated.Resultsmayprovidesomereferencetodesignandimprovethiskindofvessel.
简介:摘要目的及早识别头位难产,及时处理,以减少对母婴的危害。方法回顾性对396例因头位难产行剖宫产进行临床分析。结果1,宫口开大≥7cm时剖宫产较宫口开大<7cm时剖宫产的产后出血发生率高,差异有显著性;2,在持续性枕后(横)位、活跃期停滞、继发宫缩乏力这三种情况下巨大儿的发生率依次增高,但差异无显著性。结论及时发现头位难产,及早行剖宫产,减少产后出血的发生。出现继发性宫缩乏力时,往往合并巨大儿可能。